ES2306632T3 - ELECTRONIC COGULATION BISTURI. - Google Patents
ELECTRONIC COGULATION BISTURI. Download PDFInfo
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- ES2306632T3 ES2306632T3 ES04741728T ES04741728T ES2306632T3 ES 2306632 T3 ES2306632 T3 ES 2306632T3 ES 04741728 T ES04741728 T ES 04741728T ES 04741728 T ES04741728 T ES 04741728T ES 2306632 T3 ES2306632 T3 ES 2306632T3
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- 102000009123 Fibrin Human genes 0.000 claims abstract description 11
- 108010073385 Fibrin Proteins 0.000 claims abstract description 11
- BWGVNKXGVNDBDI-UHFFFAOYSA-N Fibrin monomer Chemical compound CNC(=O)CNC(=O)CN BWGVNKXGVNDBDI-UHFFFAOYSA-N 0.000 claims abstract description 11
- 102000008946 Fibrinogen Human genes 0.000 claims abstract description 11
- 108010049003 Fibrinogen Proteins 0.000 claims abstract description 11
- 229950003499 fibrin Drugs 0.000 claims abstract description 11
- 229940012952 fibrinogen Drugs 0.000 claims abstract description 11
- 238000004925 denaturation Methods 0.000 claims abstract description 5
- 230000036425 denaturation Effects 0.000 claims abstract description 5
- 230000015271 coagulation Effects 0.000 claims description 11
- 238000005345 coagulation Methods 0.000 claims description 11
- 230000009466 transformation Effects 0.000 claims description 4
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- 230000004048 modification Effects 0.000 claims 2
- 238000012986 modification Methods 0.000 claims 2
- 238000000034 method Methods 0.000 abstract description 7
- 230000023555 blood coagulation Effects 0.000 abstract description 3
- 230000001105 regulatory effect Effects 0.000 abstract description 3
- 230000001131 transforming effect Effects 0.000 abstract 1
- 210000004204 blood vessel Anatomy 0.000 description 9
- 239000008280 blood Substances 0.000 description 6
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- 230000000694 effects Effects 0.000 description 5
- 230000010355 oscillation Effects 0.000 description 5
- 239000013078 crystal Substances 0.000 description 3
- 238000005520 cutting process Methods 0.000 description 3
- 230000009471 action Effects 0.000 description 2
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- 230000033228 biological regulation Effects 0.000 description 2
- 230000001413 cellular effect Effects 0.000 description 2
- 230000006378 damage Effects 0.000 description 2
- 230000009849 deactivation Effects 0.000 description 2
- 230000001338 necrotic effect Effects 0.000 description 2
- 102000004169 proteins and genes Human genes 0.000 description 2
- 108090000623 proteins and genes Proteins 0.000 description 2
- 230000010349 pulsation Effects 0.000 description 2
- 239000010453 quartz Substances 0.000 description 2
- VYPSYNLAJGMNEJ-UHFFFAOYSA-N silicon dioxide Inorganic materials O=[Si]=O VYPSYNLAJGMNEJ-UHFFFAOYSA-N 0.000 description 2
- 208000002193 Pain Diseases 0.000 description 1
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- 206010022694 intestinal perforation Diseases 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1402—Probes for open surgery
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/1206—Generators therefor
- A61B18/1233—Generators therefor with circuits for assuring patient safety
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- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Engineering & Computer Science (AREA)
- Life Sciences & Earth Sciences (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Plasma & Fusion (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Physics & Mathematics (AREA)
- Otolaryngology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
- Saccharide Compounds (AREA)
- Heterocyclic Carbon Compounds Containing A Hetero Ring Having Oxygen Or Sulfur (AREA)
- Investigating Or Analyzing Materials By The Use Of Electric Means (AREA)
Abstract
Description
Bisturí electrónico de coagulación.Electronic coagulation scalpel.
La presente invención se refiere a un bisturí electrónico para coagular vasos sanguíneos, adaptado a aplicaciones quirúrgicas.The present invention relates to a scalpel electronic to coagulate blood vessels, adapted to applications Surgical
Más concretamente, tal y como se destacará mejor en la descripción que sigue, la invención se refiere a un bisturí electrónico adaptado para transferir al manipulador una potencia eléctrica y, por tanto, una energía adaptada para coagular la sangre de los vasos sanguíneos sin causar colapso a la pared del vaso.More specifically, as it will stand out better In the description that follows, the invention relates to a scalpel electronic adapted to transfer power to the manipulator electrical and, therefore, an energy adapted to coagulate the blood from the blood vessels without causing collapse to the wall of the glass.
Se sabe que la coagulación sanguínea se produce porque una sustancia proteínica disuelta en plasma, denominada fibrinógeno, durante la coagulación sanguínea se organiza en una estructura estable fibrosa denominada fibrina.It is known that blood clotting occurs because a protein substance dissolved in plasma, called fibrinogen, during blood coagulation is organized in a stable fibrous structure called fibrin.
De este modo, se obtiene una malla de fibrina, evitando que la sangre salga del vaso sanguíneo en el que fluye.In this way, a fibrin mesh is obtained, preventing blood from leaving the blood vessel in which flowing.
Por consiguiente, la mejora de la organización del fibrinógeno en fibrina significa que se reúnen las condiciones para coagular la sangre.Therefore, the improvement of the organization of fibrinogen in fibrin means that the conditions are met To clot the blood.
Las pruebas han demostrado que la coagulación, que es la transformación de fibrinógeno en fibrina se produce cuando a las moléculas del plasma dicha energía cinética se transfiere para aumentar su temperatura en, al menos, hasta 63ºC. En estas condiciones, el fibrinógeno se transforma en fibrina sin colapsar el vaso sanguíneo.Tests have shown that coagulation, which is the transformation of fibrinogen into fibrin occurs when to the plasma molecules said kinetic energy is transfers to increase its temperature by at least up to 63 ° C. Under these conditions, fibrinogen is transformed into fibrin without Collapse the blood vessel.
Si la temperatura excede de 80-85ºC, el vaso se colapsa y las células de la pared del vaso sanguíneo mueren.If the temperature exceeds 80-85 ° C, the vessel collapses and the cells of the blood vessel wall die.
Las técnicas de coagulación disponibles, en la actualidad, realizadas con bisturís electrónicos destruyen los vasos creando una zona muerta y, además, los bisturís electrónicos funcionan con valores de voltaje a niveles peligrosos, a veces, miles de voltios. El documento WO 02/053049 revela un dispositivo, tal y como se describe, en el preámbulo de la reivindicación 1.The coagulation techniques available, in the Today, made with electronic scalpels destroy the vessels creating a dead zone and, in addition, electronic scalpels they work with voltage values at dangerous levels, sometimes, thousands of volts WO 02/053049 discloses a device, as described, in the preamble of claim 1.
El peligro de los altos voltajes junto con el exceso de la energía transmitida a través de los bisturís electrónicos, destruye los tejidos de los vasos sanguíneos, tal y como se ha mencionado.The danger of high voltages along with the excess of the energy transmitted through the scalpels electronic, destroys blood vessel tissues, such and As mentioned.
Las pruebas efectuadas señalan que las células que realizan la acción del bisturí electrónico no están sujetas a degeneraciones necróticas, cuando la energía transferida para romper el enlace molecular de estas células es prácticamente igual a la energía que mantiene unido dicho enlace molecular.The tests carried out indicate that the cells who perform the action of the electronic scalpel are not subject to necrotic degenerations, when the energy transferred to break the molecular bond of these cells is practically equal to the energy that holds said molecular bond together.
De hecho, cuando se transfiere la energía a un tejido celular, se produce la vibración de las moléculas tisulares y el aumento de la energía cinética se transforma en un aumento de temperatura de dicho tejido.In fact, when the energy is transferred to a cellular tissue, the vibration of tissue molecules occurs and the increase in kinetic energy is transformed into an increase in temperature of said tissue.
Cuando la temperatura de las células asciende a los 50ºC, las células se necrosian y mueren.When the temperature of the cells rises to at 50 ° C, the cells become necrosian and die.
Por tanto, es extremadamente importante trabajar de tal manera que el bisturí electrónico realice la operación de corte sin producir calor en el tejido adyacente.Therefore, it is extremely important to work in such a way that the electronic scalpel performs the operation of cutting without producing heat in the adjacent tissue.
Además, se ha observado que el fenómeno del aumento de temperatura no se produce cuando, y sólo cuando se transfiere la energía de las moléculas tisulares, siendo equivalente a la energía del enlace molecular.In addition, it has been observed that the phenomenon of temperature rise does not occur when, and only when transfers the energy of tissue molecules, being equivalent to the molecular bond energy.
De hecho, en este caso, la energía suministrada no se utiliza para aumentar la energía cinética molecular, sino sólo para romper el enlace que une las moléculas entre sí.In fact, in this case, the energy supplied It is not used to increase molecular kinetic energy, but just to break the bond that binds the molecules together.
El objetivo de esta invención es proponer un método que regule un dispositivo electrónico para transmitir la forma de la onda al manipulador de un bisturí electrónico, así como dirigir dicho bisturí electrónico de manera que transfiera a la zona tisular a coagular una energía, prácticamente equivalente a la energía necesaria para obtener la desnaturalización proteínica que transforme el fibrinógeno contenido en plasma en fibrina, sin colapsar el vaso sanguíneo.The objective of this invention is to propose a method that regulates an electronic device to transmit the waveform to the manipulator of an electronic scalpel, as well as direct said electronic scalpel so that it transfers to the tissue area to coagulate an energy, practically equivalent to the energy needed to obtain protein denaturation that transform the fibrinogen contained in plasma into fibrin, without Collapse the blood vessel.
Otro objetivo de la invención es conseguir que la energía transferida al bisturí electrónico sea tal, de manera que no eleve la temperatura de los tejidos adyacentes a niveles que puedan colapsar el tejido del vaso sanguíneo.Another object of the invention is to achieve that the energy transferred to the electronic scalpel is such, so that does not raise the temperature of adjacent tissues to levels that They can collapse the blood vessel tissue.
En otras palabras, uno de los objetivos es lograr que la temperatura transmitida por el manipulador del bisturí electrónico al tejido a coagular nunca supere los 70-75ºC.In other words, one of the objectives is get the temperature transmitted by the scalpel manipulator electronic tissue to coagulate never exceed 70-75 ° C.
Otro objetivo es, por supuesto limitar tanto como sea posible o incluso evitar, totalmente, el colapso de los vasos sanguíneos y, por tanto, su destrucción dado que la zona que ya no recibe sangre muere, como es natural.Another objective is of course to limit both as possible or even avoid, totally, the collapse of blood vessels and, therefore, their destruction since the area that He no longer receives blood dies, naturally.
Otro objetivo más es facilitar un bisturí electrónico que emplee voltajes relativamente bajos para la coagulación, de manera que la ocasional posibilidad de que se produzca una perforación intestinal se elimina cuando se opera lejos de ello.Another objective is to facilitate a scalpel electronic that uses relatively low voltages for the coagulation, so that the occasional possibility that produce a bowel perforation is removed when operating far from it.
Los objetivos arriba mencionados y otros que se especificarán con más detalle a continuación los logra el bisturí electrónico de la invención, cuyas características principales aparecen en la reivindicación 1.The objectives mentioned above and others that are will specify in more detail then the scalpel achieves them of the invention, whose main characteristics they appear in claim 1.
Como ventaja, según la invención en lo que respecta al manipulador, se obtiene, generalmente, a intervalos regulares, paquetes de ondas resultantes de la combinación de una onda transmisora con una frecuencia equivalente a la frecuencia resonante del circuito y una serie de armónicos y una onda de modulación con una frecuencia adecuada.As an advantage, according to the invention in what With respect to the manipulator, it is generally obtained at intervals regular, wave packets resulting from the combination of a transmitter wave with a frequency equivalent to the frequency resonant circuit and a series of harmonics and a wave of modulation with an appropriate frequency.
Cada paquete de ondas disponible en el manipulador tiene una amplitud que garantiza una potencia y, por tanto, una energía que se transfiere a las células implicadas en la coagulación y que producen un ligero calor porque la energía transmitida a dichas células es distinta de la energía de enlace de las moléculas de dichas células. De este modo, se consigue calor que se sitúa en el rango de entre 65 70-75ºC pero no superior a dichas temperaturas, de manera que se obtiene el efecto de desnaturalización del fibrinógeno en fibrina, pero no la necrosis de las células adyacentes.Each wave packet available in the manipulator has an amplitude that guarantees a power and, for therefore, an energy that is transferred to the cells involved in the coagulation and that produce a slight heat because energy transmitted to these cells is different from the binding energy of the molecules of said cells. In this way, heat is achieved which is in the range between 65 70-75ºC but not higher than these temperatures, so that the effect is obtained of fibrinogen denaturation in fibrin, but not necrosis of adjacent cells.
Otra ventaja añadida es que la frecuencia de resonancia de la onda transmisora se elige, preferiblemente aunque no necesariamente, alrededor de los 4 MHz mientras que la onda de modulación puede tener la frecuencia de la alimentación eléctrica, por ejemplo, 50 ó 60 Hz o una frecuencia de 20-30 KHz.Another added advantage is that the frequency of Transmitter wave resonance is chosen, preferably although not necessarily, around 4 MHz while the wave of Modulation can have the frequency of the power supply, for example, 50 or 60 Hz or a frequency of 20-30 KHz
La presencia de un espectro de armónicos en la onda resultante hace que el manipulador transmita la potencia y, por tanto, una energía al tejido a coagular que es la suma de las diferentes energías específicas como consecuencia de las distintas frecuencias.The presence of a harmonic spectrum in the resulting wave causes the manipulator to transmit the power and, therefore, an energy to the tissue to coagulate which is the sum of the different specific energies as a result of the different frequencies
Esto es particularmente importante porque cada molécula del tejido celular a coagular de distinta naturaleza corresponde una energía ideal de transmisión a la que llegar en el caso actual, la temperatura correcta permite la transformación del fibrinógeno en fibrina sin causar daños a las demás células adyacentes.This is particularly important because each molecule of cellular tissue to coagulate of different nature corresponds an ideal transmission energy to reach in the current case, the correct temperature allows the transformation of the fibrinogen in fibrin without causing damage to other cells adjacent.
Según una representación de la presente invención, la onda de modulación resultante se obtiene activando y desactivando, a intervalos intermitentes, un circuito BUFFER que permita o evite que el oscilador de cristal o un eventual sintetizador de frecuencia que transmita su pulsación al circuito piloto del interruptor electrónico.According to a representation of this invention, the resulting modulation wave is obtained by activating and deactivating, at intermittent intervals, a BUFFER circuit that allow or prevent the crystal oscillator or eventual frequency synthesizer that transmits its pulsation to the circuit electronic switch pilot.
Por consiguiente, en este caso se consiguen trenes de pulso intermitentes dependiendo de la frecuencia, a través de la cual el microprocesador que controla el circuito BUFFER lleva a cabo su actividad de activación y desactivación.Therefore, in this case they are achieved intermittent pulse trains depending on the frequency, to through which the microprocessor that controls the BUFFER circuit carries out its activation and deactivation activity.
En otra representación de la invención la onda resultante se consigue sumando la onda transmisora generada en la frecuencia del oscilador de cristal o un eventual sintetizador de frecuencia y suministrado por el circuito piloto a la base del interruptor electrónico, a través de una onda de corriente rectificada parcialmente que se conecta al colector del interruptor electrónico.In another representation of the invention the wave resulting is achieved by adding the transmitting wave generated in the crystal oscillator frequency or eventual synthesizer of frequency and supplied by the pilot circuit to the base of the electronic switch, through a current wave partially rectified that connects to the switch manifold electronic.
La así denominada modulación básica, concretamente series de pulsos generados por efectos sobre el circuito piloto, se utiliza sobre todo para maquinaria de alta potencia mientras que la modulación del colector se emplea para maquinaria de baja potencia.The so-called basic modulation, specifically series of pulses generated by effects on the pilot circuit, it is mostly used for high machinery power while manifold modulation is used to low power machinery
Otras características de la invención se verán con más detalle en la siguiente descripción de una representación concreta de la invención, facilitada a modo de ejemplo pero no limitativo y que se muestra con los dibujos que la acompañan en donde:Other features of the invention will be seen. in more detail in the following description of a representation The invention, given by way of example but not limiting and shown with the accompanying drawings in where:
- la figura 1 es un diagrama de bloque del bisturí electrónico de la invención.- Figure 1 is a block diagram of the electronic scalpel of the invention.
- la figura 2 es un detalle del circuito de radiofrecuencia del bisturí electrónico de la figura 1, y- Figure 2 is a detail of the circuit of radiofrequency of the electronic scalpel of Figure 1, and
- la figura 3 muestra la forma de la onda de la potencia disponible en el manipulador del bisturí electrónico referido a varias frecuencias.- Figure 3 shows the waveform of the power available in the electronic scalpel manipulator referred to several frequencies.
Según una representación práctica de la invención, en vez de utilizar un transformador 11 y el circuito rectificador con filtro 20 se puede emplear un transformador estabilizado AC/DC o un transformador acoplado a un circuito rectificador con filtro que contenga un transformador estabilizado AC/DC en la salida.According to a practical representation of the invention, instead of using a transformer 11 and the circuit rectifier with filter 20 a transformer can be used AC / DC stabilized or a transformer coupled to a circuit filter rectifier containing a stabilized transformer AC / DC at the exit.
En cualquier caso, el voltaje 201 que sale de dichos circuitos rectificadores deberían ser directos y estabilizados, con un valor prefijado comprendido, a ser posible, por ejemplo entre 50 V y 200 V, en donde el valor de voltaje elegido dependa de la utilización del equipo de funcionamiento.In any case, the voltage 201 that comes out of said rectifier circuits should be direct and stabilized, with a preset value included, if possible, for example between 50 V and 200 V, where the chosen voltage value depend on the use of the operating equipment.
Como alternativa, para el mismo uso del equipo que se pretende conseguir, el voltaje puede ser distinto, según sea la función.As an alternative, for the same use of the equipment which is intended to achieve, the voltage may be different, depending on the function.
Por ejemplo, el voltaje de alimentación puede proceder de dos alimentadores con dos valores de voltaje diferentes, dependiendo de la función bipolar y de la función unipolar de dicho bisturí, presente en el mismo equipo.For example, the supply voltage can come from two feeders with two voltage values different, depending on the bipolar function and the function unipolar of said scalpel, present in the same team.
Este circuito de radiofrecuencia se muestra mejor en la figura 2.This radio frequency circuit is shown better in figure 2.
El circuito de este ejemplo utiliza dos interruptores electrónicos, como por ejemplo dos MOSFET.The circuit in this example uses two electronic switches, such as two MOSFETs.
No obstante, si un bisturí electrónico precisa potencias de corte mayores, es posible utilizar tres o más componentes MOSFET.However, if an electronic scalpel needs higher cutting powers, it is possible to use three or more MOSFET components.
Cada MOSFET 305 viene controlado por un circuito piloto 306 alimentado por el voltaje 302 suministrado mediante suministro eléctrico estabilizado de voltaje directo del tipo conocido, que no aparece en los dibujos, en el que es posible regular el voltaje de salida que también puede ser del tipo interruptor, para mejorar su eficacia.Each MOSFET 305 is controlled by a circuit pilot 306 powered by voltage 302 supplied by direct voltage stabilized electrical supply of the type known, which does not appear in the drawings, in which it is possible regulate the output voltage that can also be of the type switch, to improve its efficiency.
El circuito piloto 306 también se regula mediante un control de corriente 310 formado, entre otros, por un microprocesador 314 que interrumpe, a intervalos predeterminados, la alimentación del circuito piloto, de manera que la onda resultante que pasa por el circuito resonante toma la forma de una serie de pulsos intermitente, cada uno de ellos formado por una onda de modulación de amplitud.Pilot circuit 306 is also regulated by means of a current control 310 formed, among others, by a microprocessor 314 that interrupts, at predetermined intervals, pilot circuit power, so that the wave resulting that passes through the resonant circuit takes the form of a series of intermittent pulses, each formed by a wave of amplitude modulation.
Más concretamente, el circuito de radiofrecuencia 30 hace que cada MOSFET 305 actúe como interruptor rompiendo la corriente directa procedente del voltaje de salida 201 del circuito rectificador 20 y aplicado al colector de cada MOSFET.More specifically, the circuit of radio frequency 30 makes each MOSFET 305 act as a switch breaking the direct current from the output voltage 201 of the rectifier circuit 20 and applied to the collector of each MOSFET
Cada circuito piloto 306 emite una onda unidireccional cuadrada de pulsación no alternada 304 que conduce la base de cada MOSFET.Each pilot circuit 306 emits a wave Unidirectional square of non-alternating pulsation 304 leading the base of each MOSFET.
La frecuencia del circuito piloto 306 se mantiene constante a través de un oscilador de cuarzo 311 con una frecuencia de oscilación de 4 MHz conectada a un BUFFER 313.The frequency of the pilot circuit 306 is keeps constant through a 311 quartz oscillator with a 4 MHz oscillation frequency connected to a BUFFER 313.
La frecuencia de oscilación básica de 4 MHz, y las frecuencias superiores también, se pueden obtener asimismo mediante un circuito o un dispositivo electrónico específico, como por ejemplo un sintetizador de frecuencia.The basic oscillation frequency of 4 MHz, and higher frequencies too, can also be obtained by means of a circuit or a specific electronic device, such as for example a frequency synthesizer.
El control de MOSFET 305 se produce a través de una señal que tiene una frecuencia de oscilación equivalente a la del cuarzo, o del circuito o dispositivo adecuados, que en el caso de este ejemplo es de 4MHz.MOSFET 305 control occurs through a signal that has an oscillation frequency equivalent to the of the quartz, or of the appropriate circuit or device, which in the case This example is 4MHz.
El MOSFET 305 cuando está cerrado interrumpe la corriente de la pata 301 y cuando está abierto permite el paso de la corriente a la pata 301.MOSFET 305 when closed interrupts the leg current 301 and when open allows the passage of the current at leg 301.
El ancho de la forma de onda de corriente en el 301 depende de la regulación de la señal 302 conectada al circuito piloto 306.The width of the current waveform in the 301 depends on the regulation of signal 302 connected to the circuit pilot 306.
La regulación de la señal en el 302, producida por un potenciómetro 303, o por ejemplo por un regulador del tipo de pantalla táctil, permite elegir la anchura de la onda de salida, de manera que se puede obtener la potencia deseada por el manipulador 41 del bisturí electrónico, según la operación que se realice.The regulation of the signal in 302, produced by a potentiometer 303, or for example by a regulator of the type Touch screen, allows you to choose the width of the output wave, so that the desired power can be obtained by the manipulator 41 of the electronic scalpel, according to the operation perform.
La siguiente tabla muestra las máximas potencias en algunos campos de aplicación, utilizando el bisturí de la invención en operaciones de corte, según los campos de intervención quirúrgica.The following table shows the maximum powers in some fields of application, using the scalpel of the invention in cutting operations, according to the intervention fields surgical
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De la tabla 1 se puede ver que la potencia máxima empleada puede oscilar entre valores inferiores a 25 vatios, para pequeñas intervenciones de neurocirugía, hasta un máximo de 120 vatios.From table 1 you can see that the power Maximum employed can range between values below 25 watts, for small neurosurgery interventions, up to a maximum of 120 watts
A fin de conseguir un método de ajuste de potencia que sea distinto al descrito en el ejemplo, que consiga el ajuste de potencia por variación del voltaje de alimentación 302 de los circuitos de control que pilotan la potencia de las puertas MOSFET, se puede utilizar un voltaje 201 directo y estabilizado (mediante un transformador AC/DC o DC/DC), pero variable por ejemplo entre 0 y 200 V, mientras se mantiene constante el voltaje 302.In order to achieve an adjustment method of power that is different from the one described in the example, that gets the power adjustment by variation of the supply voltage 302 of the control circuits that pilot the power of the doors MOSFET, a direct and stabilized voltage 201 can be used (using an AC / DC or DC / DC transformer), but variable for example between 0 and 200 V, while the voltage 302 remains constant.
Otra posibilidad es usar el voltaje estabilizado directo 201, variable por ejemplo entre 0 y 200 V, y el voltaje variable 302 también para obtener, en este caso, un ajuste de potencia de tipo mixto.Another possibility is to use the stabilized voltage direct 201, variable for example between 0 and 200 V, and the voltage variable 302 also to obtain, in this case, an adjustment of mixed type power.
Según una posible representación de la invención, la frecuencia de oscilación básica de 4 MHz se modula a través de la intervención del microprocesador 314, siendo parte del control de corriente 310 dispuesto para transferir al circuito BUFFER una señal de activación o desactivación de dicho circuito con una frecuencia de 20-30 KHz y con un coeficiente de utilización inferior al 30%.According to a possible representation of the invention, the basic oscillation frequency of 4 MHz is modulated to through the intervention of microprocessor 314, being part of the 310 current control arranged to transfer to the circuit BUFFER an activation or deactivation signal of said circuit with a frequency of 20-30 KHz and with a coefficient of utilization less than 30%.
De este modo, el circuito BUFFER 310 transmite y rompe la oscilación generada por el oscilador 311, generando así una serie de pulsos que llegan al circuito piloto 306, la base del interruptor electrónico MOSFET 305.In this way, the BUFFER 310 circuit transmits and breaks the oscillation generated by oscillator 311, thus generating a series of pulses that reach the pilot circuit 306, the base of the MOSFET 305 electronic switch.
La onda resultante 301 procedente de los interruptores MOSFET 305 es, por tanto, una onda modulada cuya amplitud queda regulada por el regulador de potencia 303.The resulting wave 301 from the MOSFET 305 switches is therefore a modulated wave whose amplitude is regulated by power regulator 303.
Según otra representación de la invención, se podría obtener una onda resultante modulada en vez de actuar sobre la interrupción del oscilador de cristal 311, alimentando los interruptores electrónicos MOSFET 305 con un voltaje 201 que ya no será directo sino que será un voltaje pulsátil rectificado parcialmente (con una onda media única).According to another representation of the invention, could get a resulting modulated wave instead of acting on the interruption of the crystal oscillator 311, feeding the MOSFET 305 electronic switches with a voltage 201 that is no longer it will be direct but it will be a rectified pulsating voltage partially (with a single medium wave).
Con el fin de conseguir esto, es suficiente modificar el circuito de rectificación 20, de manera que la señal 201 proceda de dicho circuito sin la onda media negativa y lleve sólo la parte positiva de la onda sinusoidal de la red eléctrica.In order to achieve this, it is enough modify the rectification circuit 20, so that the signal 201 proceed from said circuit without the negative mean wave and carry only the positive part of the sine wave of the network electric
También en este caso, se obtiene una corriente de salida 301 del circuito de radiofrecuencia con una onda resultante formada por una onda transmisora a 4 MHz y una onda de modulación a 50-60 KHz.Also in this case, a current is obtained output 301 of the radio frequency circuit with a wave resulting formed by a 4 MHz transmitter wave and a wave of 50-60 KHz modulation.
Al conectarse la salida del circuito de radiofrecuencia 30 al transformador de radiofrecuencia primario 40, se establece una corriente circulatoria 301 que pasa a través del circuito resonante a la frecuencia de 4 MHz, donde se facilitan la capacidad e inductancia del circuito resonante que vienen dadas por la capacidad parásita de MOSFET 305, el condensador 307 de reactancia insignificante pero que actúa como bloqueo del componente directo de un voltaje 201 y la inductancia del circuito primario del transformador 40, respectivamente.When the output of the circuit is connected radiofrequency 30 to the primary radiofrequency transformer 40, a circulatory current 301 is established that passes through the resonant circuit at the frequency of 4 MHz, where the capacity and inductance of the resonant circuit that are given by the parasitic capacity of MOSFET 305, the capacitor 307 of insignificant reactance but that acts as a blockage of the direct component of a voltage 201 and the circuit inductance primary of transformer 40, respectively.
Conforme a la invención, el circuito resonante sobre la frecuencia de la portadora es del tipo de paso banda ancha, de manera que deja pasarla incluso humectada, al menos el segundo y tercer armónico de la onda transmisora relativa a la señal 301.According to the invention, the resonant circuit About the carrier frequency is the band pass type wide, so that it passes even humidified, at least the second and third harmonic of the signal wave relative to the signal 301
Se prefiere que la señal 301 tenga, al menos, el segundo, tercer y cuarto armónico.It is preferred that the signal 301 has at least the second, third and fourth harmonic.
Para obtener un circuito resonante de paso banda ancha en la representación de la figura 2, se empleó un transformador de alta frecuencia con una serie de giros del circuito secundario superior al número de giros del circuito primario.To obtain a resonant bandpass circuit wide in the representation of figure 2, a high frequency transformer with a series of circuit turns secondary higher than the number of turns of the primary circuit.
Esto porque, como es conocido, el coeficiente de resonancia Q se proporciona mediante esta fórmula:This is because, as is known, the coefficient of Q resonance is provided by this formula:
en donde la F es la frecuencia de resonancia. C_{R} es la capacidad del circuito resonante, R_{E} es la resistencia equivalente del circuito primario, cuando se aplica una carga al circuito secundario formado por ejemplo, por el cuerpo de un paciente a operar con el bisturí electrónico.where F is the frequency of resonance. C_ {R} is the capacity of the resonant circuit, R_ {E} is the equivalent resistance of the primary circuit, when applies a load to the secondary circuit formed for example by the a patient's body to operate with the scalpel electronic.
La resistencia equivalente se puede expresar con la siguiente fórmula:The equivalent resistance can be expressed with The following formula:
donde R_{C} es la resistencia de carga y N_{1} y N_{2} es el número de giros del circuito primario y secundario, respectivamente; uno puede observar que el factor de resonancia Q puede expresarse mediante la fórmula:where R_ {C} is the resistance of load and N_ {1} and N_ {2} is the number of turns of the circuit primary and secondary, respectively; one can observe that the resonance factor Q can be expressed by the formula:
La fórmula indica que el coeficiente de resonancia disminuye cuando el número de giros secundario aumenta, con respecto al de giros primario.The formula indicates that the coefficient of resonance decreases when the number of secondary turns increases, with respect to the primary turn.
El coeficiente de resonancia también puede expresarse mediante la fórmula:The resonance coefficient can also Expressed by the formula:
Q = BQ = B
En donde F_{R} es la frecuencia de resonancia y B es el paso de banda.Where F_ {R} is the resonant frequency and B is the band pass.
En el caso de la presente invención, cuando se quiera ampliar el paso de banda de 4 MHz a 8 MHz, 12 MHz y 16 MHz, en el circuito resonante se insertará un transformador con un número adecuado de giros, de manera que el coeficiente de resonancia sea inferior a 1, preferiblemente entre 0,4 y 0,6.In the case of the present invention, when want to extend the bandwidth from 4 MHz to 8 MHz, 12 MHz and 16 MHz, a transformer with a number will be inserted in the resonant circuit adequate rotation so that the resonance coefficient is less than 1, preferably between 0.4 and 0.6.
La onda de modulación que también circula sobre el circuito resonante a la frecuencia de la onda transmisora, genera varias ondas con una frecuencia procedente de la resonancia.The modulation wave that also circulates on the resonant circuit at the frequency of the transmitting wave, generates several waves with a frequency from the resonance.
Por este motivo, la onda resultante es rica en ondas procedente de la frecuencia de resonancia produciendo el efecto de aumentar la temperatura del tejido de sangre a coagular.For this reason, the resulting wave is rich in waves from the resonant frequency producing the effect of increasing blood tissue temperature to coagulate.
Estas ondas procedentes de la frecuencia de resonancia pueden transferirse al manipulador porque el coeficiente de resonancia del circuito resonante es lo suficientemente bajo.These waves coming from the frequency of resonance can be transferred to the manipulator because the coefficient resonance of the resonant circuit is enough low.
Con estas características de paso de banda ancha del circuito resonante, la señal de corriente secundaria del transformador en 401 toma la forma mostrada en la figura 3.With these broadband pass features of the resonant circuit, the secondary current signal of the Transformer in 401 takes the form shown in Figure 3.
Comprobando la forma de onda de la figura 3, se puede ver que a 4, 8, 12 y 16 MHz existen picos de potencia que son interesantes y que se transfieren al manipulador del bisturí con los efectos arriba mencionados.Checking the waveform of Figure 3, it you can see that at 4, 8, 12 and 16 MHz there are power peaks that are interesting and that are transferred to the scalpel manipulator with the effects mentioned above.
Más concretamente, se ha observado que la coagulación obtenida en los tejidos sanguíneos es inmediata y eficaz.More specifically, it has been observed that the coagulation obtained in blood tissues is immediate and effective.
El tejido circundante no se necrosia porque el aumento de temperatura a 70-75ºC queda limitado a la zona de coagulación y no afecta a la zona del tejido adyacente.The surrounding tissue is not necrotic because the temperature rise to 70-75ºC is limited to the coagulation zone and does not affect the adjacent tissue area.
La transformación de fibrinógeno en fibrina es casi inmediata.The transformation of fibrinogen into fibrin is almost immediate
Se puede ver que la corriente de la señal 401, una vez instalado el regulador de potencia 302, queda controlada a través del control de corriente procedente de un sensor de corriente 308 dispuesto detrás de MOSFET 305.You can see that the signal current 401, Once the power regulator 302 is installed, it is controlled by through the current control from a sensor stream 308 arranged behind MOSFET 305.
La señal de voltaje 309 procedente del sensor de corriente 308 conduce el control de corriente 310 provisto para limitar los comparadores rápidos, a través del microprocesador 314 o por el propio microprocesador, la corriente máxima 401 que actúa con la señal 312 sobre el circuito piloto del MOSFET.The voltage signal 309 from the sensor current 308 conducts current control 310 provided for limit fast comparators, through microprocessor 314 or by the microprocessor itself, the maximum current 401 that acts with signal 312 on the pilot circuit of the MOSFET.
En caso de impedancia baja, al aumentar la corriente a valores muy altos, en el circuito hay un limitador de corriente formado por la inductancia 402 que limita la corriente al manipulador e impidiendo que el circuito exceda el valor de corriente máximo admisible.In case of low impedance, by increasing the current at very high values, in the circuit there is a limiter of current formed by inductance 402 that limits the current to manipulator and preventing the circuit from exceeding the value of maximum allowable current.
El circuito eléctrico se cierra a través de la carga óhmica del paciente entre dos electrodos que son el manipulador 41 y un electrodo de placa 42.The electrical circuit closes through the ohmic load of the patient between two electrodes that are the manipulator 41 and a plate electrode 42.
La placa 42 se cubre, preferiblemente, con una capa aislante ligera para evitar que la placa choque contra el paciente, típico de los bisturís electrónicos.The plate 42 is preferably covered with a lightweight insulating layer to prevent the plate from bumping against the patient, typical of electronic scalpels.
Se puede ver que el ensamblaje del electrodo formado por el manipulador 41 y la placa 42 también pueden tomar diferentes formas de tenazas con funcionamiento bipolar.You can see that the electrode assembly formed by manipulator 41 and plate 42 can also take different forms of pliers with bipolar operation.
Con el método de ajuste de potencia del bisturí electrónico de coagulación de la invención, es posible disponer de una energía en el manipulador que es prácticamente equivalente a la necesaria para tener, en las células interesadas por la acción de coagulación, un aumento de la temperatura suficiente como para producir la desnaturalización del fibrinógeno, pero inferior a la temperatura que provocaría la muerte de las células tisulares adyacentes.With the scalpel power adjustment method electronic coagulation of the invention, it is possible to have an energy in the manipulator that is practically equivalent to the necessary to have, in the cells interested in the action of coagulation, an increase in temperature sufficient to produce fibrinogen denaturation, but less than temperature that would cause the death of tissue cells adjacent.
Como se puede observar, la dosificación de dicha energía se obtiene variando la amplitud de la señal de potencia aplicada al circuito piloto o a la alimentación 201.As can be seen, the dosage of said energy is obtained by varying the amplitude of the power signal applied to the pilot circuit or to the supply 201.
La consecuencia de ese tipo de dosificación de energía del manipulador es reducir, al menos, los dolores del post-operatorio para reducir considerablemente el tiempo de permanencia del paciente en el hospital tras la operación quirúrgica y, en consecuencia, reducir los costes de hospitalización.The consequence of that type of dosage of energy of the manipulator is to reduce, at least, the pains of post-operative to significantly reduce the patient time in the hospital after the operation surgical and, consequently, reduce the costs of hospitalization.
El bisturí de coagulación de la invención se puede utilizar también sin ningún problema para intervenciones en pacientes con marcapasos, debido a que las frecuencias empleadas por el bisturí de la invención no interfieren con el funcionamiento correcto del marcapasos.The coagulation scalpel of the invention is you can also use without any problem for interventions in pacemaker patients, because the frequencies used by The scalpel of the invention does not interfere with the operation Correct pacemaker.
Claims (13)
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- un circuito rectificador (20) alimentado por una red de voltaje en línea que suministra un voltaje (201) a un circuito de radiofrecuencia;a rectifier circuit (20) powered by a voltage network in line that supplies a voltage (201) to a circuit of radiofrequency;
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- un circuito de radiofrecuencia (30) formado por, al menos, un interruptor electrónico (305) alimentado por dicho voltaje (201); dicho interruptor electrónico es controlado por un circuito piloto (306).a radiofrequency circuit (30) formed by at least one electronic switch (305) powered by said voltage (201); said electronic switch is controlled by a pilot circuit (306).
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| IT000111A ITVI20030111A1 (en) | 2003-06-06 | 2003-06-06 | ELECTRONIC SCALPEL FOR COAGULATION. |
| ITVI03A0111 | 2003-06-06 |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| ES2306632T1 ES2306632T1 (en) | 2008-11-16 |
| ES2306632T3 true ES2306632T3 (en) | 2009-12-15 |
Family
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| ES04741728T Expired - Lifetime ES2306632T3 (en) | 2003-06-06 | 2004-06-03 | ELECTRONIC COGULATION BISTURI. |
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| Country | Link |
|---|---|
| US (1) | US7713267B2 (en) |
| EP (1) | EP1631203B1 (en) |
| CN (1) | CN100370954C (en) |
| AT (1) | ATE440553T1 (en) |
| DE (1) | DE602004022804D1 (en) |
| ES (1) | ES2306632T3 (en) |
| IT (1) | ITVI20030111A1 (en) |
| RU (1) | RU2304934C2 (en) |
| WO (1) | WO2004107994A1 (en) |
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-
2003
- 2003-06-06 IT IT000111A patent/ITVI20030111A1/en unknown
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2004
- 2004-06-03 US US10/525,046 patent/US7713267B2/en not_active Expired - Lifetime
- 2004-06-03 CN CNB2004800155083A patent/CN100370954C/en not_active Expired - Lifetime
- 2004-06-03 ES ES04741728T patent/ES2306632T3/en not_active Expired - Lifetime
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- 2004-06-03 AT AT04741728T patent/ATE440553T1/en not_active IP Right Cessation
- 2004-06-03 EP EP04741728A patent/EP1631203B1/en not_active Revoked
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| WO2004107994A1 (en) | 2004-12-16 |
| ES2306632T1 (en) | 2008-11-16 |
| EP1631203B1 (en) | 2009-08-26 |
| RU2005110193A (en) | 2005-11-10 |
| US7713267B2 (en) | 2010-05-11 |
| EP1631203A1 (en) | 2006-03-08 |
| ITVI20030111A1 (en) | 2004-12-07 |
| RU2304934C2 (en) | 2007-08-27 |
| ATE440553T1 (en) | 2009-09-15 |
| US20060167446A1 (en) | 2006-07-27 |
| CN1798526A (en) | 2006-07-05 |
| CN100370954C (en) | 2008-02-27 |
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